Additional Role of Transabdominal Ultrasonography on Esophagogastroduodenoscopy for Uninvestigated Dyspepsia: A Prospective Study.

BACKGROUND AND AIM: Dyspepsia is a common issue worldwide, primarily caused by gastroduodenal disorders. Esophagogastroduodenoscopy (EGD) is the standard investigation of uninvestigated dyspepsia (UID), whereas transabdominal ultrasonography (TUS) is used to evaluate various hepatopancreatobiliary diseases that may mimic dyspeptic symptoms. TUS is widely used among physicians, even though the diagnostic yield remains unclear. This study is aimed at assessing the additional benefit of TUS on EGD in investigating the etiologies of dyspepsia. METHODS: This prospective study included patients with UID indicating for EGD at the Division of Gastroenterology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. All patients underwent both EGD and TUS within 1 month. Lesions identified by both methods were recorded and classified based on their potential to explain dyspepsia. Clinical data and reasons for EGD were also collected. RESULTS: Three hundred and seventy patients with a mean age of 59 were included in the analysis. Dyspepsia-relevant endoscopic findings were present in 24.1% with common diagnoses including erosive gastritis/duodenitis, peptic ulcer, and erosive esophagitis. Helicobacter pylori was detected in 23.5%. No dyspepsia-relevant ultrasonographic findings were noted, though 9.5% of patients had ultrasonographic lesions requiring further investigation. No gastroesophageal and hepatopancreatobiliary cancers were detected. CONCLUSION: EGD provides some diagnostic information for dyspeptic patients, with additional TUS offering limited benefit. TUS findings rarely contributed to the diagnosis or necessitated further intervention, indicating that it does not enhance the diagnostic yield of EGD in this study.